I recall with anguish and disgust a coterie of college progressives who would make regular pronouncements about the need for “power to the people,” then would systematically go through the pages of the dormitory facebook, rating and ripping on the students one by one. I shudder to imagine the conversation they might have around the social utility of withholding care from your grandmother (or one of theirs).

Not only am I inherently distrustful of those who claim to be swayed by the interests of “the people,” but on a more practical level, I’m not sure it’s even possible to meaningfully weigh these two factors in a particular instance – an argument made cogently by Milton Weinstein here.

We clearly live in a world of limited resources – though I admit I’ve always been a deep believer in Paul Famer’s view that we should aspire to provide the best medical care to each patient, and not accept a lower standard of care for the poor or, as I increasingly worry about, the elderly.

Perhaps (and it pains me to say this), physicians have something to learn from our colleagues in the law. It could be that we are better served by an adversarial system of some kind, where at least you can trust your doctor, rather than by a system in which physician’s role is to assess not only your disease but your relative value to society.

We’re not there yet, but when I read about the supposed moral imperative to be responsible stewards of the public healthcare dollar – yes, I worry. And so should you.

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Starting this year your child (or children) cannot be denied coverage simply because they have a pre-existing health condition. If you don’t have insurance for you and your children search “Penny Health” online they are the best.

It is a fiction that doctors always labor in their patients’ best interest. This assumes, first and foremost, that you can afford a doctor. Many Americans cannot. They’re grateful for what they’re given. Then there is the little matter of insurance providers and drug manufacturers, who interfere mightily in the quality of care rendered. Lastly, there is the issue of health providers’ accustomed lifestyles, which for most is slightly richer than the average American’s. These factors all bear on the quality of care provided and received. Adding to them a concern for the efficient use of medical resources, so that more Americans can benefit by the personal care you idealize, is hardly a make or break issue.

I’ve received some of the best medical care in my life in Denmark, where doctors are monitored closely and resources allocated rationally on a society-wide basis. I didn’t perceive a diminution of care; on the contrary, with the profit motive tamped down, my care was superior to what I have often received in the USA, even though I am insured to the gills — or is that, in spite of it.

(My current doctors, btw, are paragons of parsimony, yet I am treated better than ever. I know for a fact they are concerned about the social aspects of healthcare: it is what makes them professionals and not barbers with stethoscopes.